When cervical cancer is detected in its earliest stages, treatment is more likely to be successful. Most guidelines suggest beginning screening for cervical cancer and precancerous changes at age 21. Screening for cervical cancer includes:
- Pap test. During a Pap test, your doctor scrapes and brushes cells from your cervix — the narrow neck of the uterus — and sends the sample to a lab to be examined for abnormalities. A Pap test can detect abnormal cells in the cervix, including cancer cells and cells that show changes (dysplasia) that increase the risk of cervical cancer.
- HPV DNA test. If you are age 30 or older, your doctor may also use a lab test called the HPV DNA test to determine whether you are infected with any of the types of HPV that are most likely to lead to cervical cancer. Like the Pap test, the HPV DNA test involves collecting cells from the cervix for lab testing.
If you experience signs and symptoms of cervical cancer or if a Pap test has revealed cancerous cells, you may undergo further tests to diagnose your cancer. To make a diagnosis, your doctor may:
- Examine your cervix. During an exam called colposcopy, your doctor uses a special magnifying instrument (colposcope) to examine your cervix for abnormal cells. If your doctor identifies unusual areas, he or she may take a small sample of cells for analysis (biopsy).
- Take a sample of cervical cells. During a biopsy procedure, your doctor removes a sample of unusual cells from your cervix using special biopsy tools.
- Remove a cone-shaped area of cervical cells. A cone biopsy (conization) — so called because it involves taking a cone-shaped sample of the cervix — allows your doctor to obtain deeper layers of cervical cells for laboratory testing. Your doctor may use a scalpel, laser or electrified wire loop to remove the tissue.
If your doctor determines that you have cervical cancer, you'll undergo further tests to determine the extent (stage) of your cancer. Your cancer's stage is a key factor in deciding on your treatment. Staging exams include:
- Imaging tests. Tests such as X-rays, computerized tomography (CT) scans, magnetic resonance imaging (MRI) and positron emission tomography (PET) help your doctor determine whether your cancer has spread beyond your cervix.
- Visual examination of your bladder and rectum. Your doctor may use special scopes to see inside your bladder (cystoscopy) and rectum (proctoscopy).
Your doctor then assigns your cancer a stage — typically a Roman numeral. Stages of cervical cancer include:
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- Stage I. Cancer is confined to the cervix.
- Stage II. Cancer at this stage includes the cervix and vagina but hasn't spread to the pelvic side wall or the lower portion of the vagina.
- Stage III. Cancer at this stage has moved beyond the cervix to the pelvic side wall or the lower portion of the vagina.
- Stage IV. At this stage, cancer has spread to nearby organs, such as the bladder or rectum, or it has spread to other areas of the body, such as the lungs, liver or bones.
- Abeloff MD, et al. Abeloff's Clinical Oncology. 4th ed. Philadelphia, Pa.: Churchill Livingstone Elsevier; 2008. http://www.mdconsult.com/das/book/body/208746819-4/0/1709/0.html. Accessed May 8, 2013.
- Cervical cancer. Fort Washington, Pa.: National Comprehensive Cancer Network. http://www.nccn.org/professionals/physician_gls/f_guidelines.asp. Accessed May 8, 2013.
- What you need to know about cervical cancer. National Cancer Institute. http://www.cancer.gov/cancertopics/wyntk/cervix. Accessed May 8, 2013.
- Lentz GM, et al. Comprehensive Gynecology. 6th ed. Philadelphia, Pa.: Mosby Elsevier; 2012. http://www.mdconsult.com/books/linkTo?type=bookPage&isbn=978-0-323-06986-1&eid=4-u1.0-B978-0-323-06986-1..C2009-0-48752-X--TOP. Accessed May 8, 2013.
- Cervical cancer screening. Fort Washington, Pa.: National Comprehensive Cancer Network. http://www.nccn.org/professionals/physician_gls/f_guidelines.asp. Accessed May 8, 2013.
- HPV (human papillomavirus) vaccine: Gardasil. What you need to know. Centers for Disease Control and Prevention. http://www.cdc.gov/vaccines/vac-gen/side-effects.htm#hpvgardasil. Accessed May 8, 2013.
- HPV (human papillomavirus) vaccine: Cervarix. What you need to know. Centers for Disease Control and Prevention. http://www.cdc.gov/vaccines/vac-gen/side-effects.htm#hpvgardasil. Accessed May 8, 2013.
- Committee on Infectious Diseases. HPV vaccine recommendations. Pediatrics. 2012;129:602.
- Taking time: Support for People with Cancer. National Cancer Institute. http://cancer.gov/cancertopics/takingtime. Accessed May 9, 2013.
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